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晚期胆囊癌(GBC)的化疗:系统评价和荟萃分析。

Chemotherapy for advanced gallbladder cancer (GBC): A systematic review and meta-analysis.

机构信息

Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, United Kingdom.

Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom.

出版信息

Crit Rev Oncol Hematol. 2021 Jul;163:103328. doi: 10.1016/j.critrevonc.2021.103328. Epub 2021 Apr 20.

Abstract

BACKGROUND

The benefit from chemotherapy, specifically for patients with gallbladder cancer (GBC), has been poorly explored since GBC is mostly studied jointly with other biliary tract cancers (BTC).

METHODS

Eligible studies reporting outcome of palliative systemic chemotherapy for advanced GBC were identified through MEDLINE, cross-referencing and conferences (PROSPERO-CRD42019155745). Meta-analysis of proportions and calculation of pooled weighted means were performed.

RESULTS

58 eligible studies (n = 1,986 patients); cisplatin/gemcitabine (33 % of patients), gemcitabine/oxaliplatin (14 %) or gemcitabine monotherapy (9%). Estimated pooled overall radiological response rate(ORR), and pooled weighted mean progression-free (PFS) and overall survivals (OS) were 23.2 % (95 %-CI 20.0-26.5) (I: 52.5 % (p < 0.001)), 4.8 months (95 %-CI 4.3-5.2) and 8.3 months (95 %CI 7.6-8.9), respectively. Patients with non-GBC BTCs achieved a lower ORR than GBC [odds ratio 0.65 (95 % CI, 0.50-0.84)].

CONCLUSIONS

GBC benefit from chemotherapy differs from other BTCs, with shorter PFS/OS despite higher ORR; new treatment options are urgently required for management of advanced GBC.

摘要

背景

由于胆囊癌(GBC)通常与其他胆道癌(BTC)一起研究,因此对化疗的益处,特别是对 GBC 患者的益处,研究甚少。

方法

通过 MEDLINE、交叉引用和会议,确定了报告晚期 GBC 姑息性全身化疗结果的合格研究(PROSPERO-CRD42019155745)。对比例进行了荟萃分析,并计算了合并加权平均值。

结果

58 项合格研究(n=1986 例患者);顺铂/吉西他滨(33%的患者)、吉西他滨/奥沙利铂(14%)或吉西他滨单药治疗(9%)。估计的合并总体影像学缓解率(ORR)、合并加权平均无进展生存期(PFS)和总生存期(OS)分别为 23.2%(95%CI 20.0-26.5)(I:52.5%(p<0.001))、4.8 个月(95%CI 4.3-5.2)和 8.3 个月(95%CI 7.6-8.9)。非 GBC BTC 患者的 ORR 低于 GBC [比值比 0.65(95%CI,0.50-0.84)]。

结论

尽管 GBC 的 ORR 更高,但与其他 BTC 相比,GBC 从化疗中获益不同,其 PFS/OS 更短;迫切需要新的治疗选择来治疗晚期 GBC。

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